Detroit Medical Center, Michigan State College of Osteopathic Medicine, Detroit, MI 48201, USA.
Urology. 2012 Jan;79(1):222-6. doi: 10.1016/j.urology.2011.09.017. Epub 2011 Nov 8.
To report our experience with an adult vesicocutaneous Mitrofanoff, an alternative to standard appendiceal or ileal Mitrofanoff.
Retrospective chart review was performed on 3 patients who underwent a vesicocutaneous Mitrofanoff by a single surgeon. Data were collected on etiology, complications, and number of procedures to correct the complication.
Indications for the procedure included neurogenic bladder and urinary retention. Mean follow-up time was 485 days with mean time to first complication of 24 days. One-hundred percent of patients saw stenosis and dehiscence of their wounds. All 3 patients required subsequent surgery. Sixty-six percent required reoperation to the standard Mitrofanoff with a mean time to this procedure of 222 days. The mean number of procedures was 4 (range 2-6).
Continent catheterizable stomas have been a continuous challenge for adults who have had multiple abdominal surgeries, making a typical appendix, ureter, or small bowel Mitrofanoff difficult. We looked at our experience with a cutaneous Mitrofanoff (an extraperitoneal procedure often done in pediatrics but never before in adults) as an alternative but found complication rates of 100%. These included stenosis and dehiscence eventually requiring reoperation, with some even requiring conversion to an ileal or appendiceal Mitrofanoff. Although there are high complication rates in the standard Mitrofanoff, we conclude that a vesicocutaneous Mitrofanoff is not an effective alternative.
报告我们在成人膀胱黏膜皮肤 Mitrofanoff 手术方面的经验，这是标准阑尾或回肠 Mitrofanoff 的替代方法。
对一位外科医生进行的 3 例膀胱黏膜皮肤 Mitrofanoff 手术的患者进行回顾性图表分析。收集病因、并发症以及纠正并发症所需的手术次数的数据。
手术指征包括神经性膀胱和尿潴留。平均随访时间为 485 天，首次出现并发症的平均时间为 24 天。所有患者均出现伤口狭窄和裂开。所有 3 例患者均需要后续手术。66%的患者需要对标准 Mitrofanoff 进行再次手术，平均时间为 222 天。平均手术次数为 4 次（范围为 2-6 次）。
对于有多次腹部手术史的成年人来说，可控性膀胱造口术一直是一个持续的挑战，这使得典型的阑尾、输尿管或小肠 Mitrofanoff 手术变得困难。我们研究了我们在皮肤 Mitrofanoff 方面的经验（这是一种常在儿科进行但从未在成人中进行的腹膜外手术），作为一种替代方法，但发现其并发症发生率为 100%。这些并发症包括狭窄和裂开，最终需要再次手术，有些患者甚至需要转换为回肠或阑尾 Mitrofanoff。尽管标准 Mitrofanoff 的并发症发生率较高，但我们得出结论，膀胱黏膜皮肤 Mitrofanoff 不是一种有效的替代方法。
